Telehealth is an emerging technology that has potential to serve the healthcare needs of individuals who live beyond easy access to specialized healthcare. Organ transplant recipients require a high level of specialized care, and because of the complexity of their medical condition, healthcare is offered only in transplant centers located in large metropolitan areas frequently long distances from their homes. Telehealth then, has the potential to serve transplant recipients. Patient outcomes studies are needed in order to determine if complex long-term medical care can be provided via telehealth. This study will compare patient outcomes of transplant recipients, with care provided by nurse practitioners (NPs), between standard care and care delivered via telehealth. As with all Transplant Centers, patients must remain connected with the Transplant Center for frequent clinic appointments. Transplant recipients require on-going surveillance to prevent or detect early rejection as well as to monitor immunosuppressive drug levels and follow other co morbid conditions. The Mid South Telehealth Consortium located throughout the state currently provides services to patients who would otherwise have to travel to the Memphis area to obtain specialized health care from physicians. Our goal is to combine the existing telehealth system with the Transplant NP clinic in order to compare the patient outcomes between standard care and the telehealth intervention for this medically complex transplant population. Transplant recipients will be randomized by type of organ transplanted into either standard care of telehealth care. The uniqueness of this study is that the healthcare for this medically complex population is provided by NPs via an established video telehealth system. This study has three overall aims: Aim 1 - Compare event-free survival in transplant recipients who receive care via telehealth experience when compared to the standard care group. Aim 2 - Compare overall adherence and satisfaction between the two delivery systems. Aim 3 - Determine differences in cost effectiveness with hospitalizations or delivery of healthcare. [unreadable] [unreadable]